When there are problems with the electrical signals in the heart, the result is arrhythmia-irregular heartbeat. These problems are treated by electrophysiologists.
Electrophysiologists can use many tests and treatments just like other cardiologists. However, electrophysiologists can also perform specialized tests called electrophysiology studies (EPS), which can also allow procedures such as pacemaker placement, insertion of an implantable cardioverter defibrillator (ICD), or catheter ablation to treat arrhythmia.
How is an electrophysiologist different from a cardiologist?
The heart has two main functions: to pump blood throughout the body and to do it efficiently and rhythmically. The actual pumping of blood is very mechanical and the problems that arise in this area are of a circulatory or structural nature.
Cardiologists are medical professionals who treat and correct problems such as coronary heart disease, congestive heart failure, cardiac arrest, or peripheral artery disease.
Heart rhythm disorders, on the other hand, arise from problems in the heart's electrical system that controls the heartbeat. When there is a problem here called arrhythmia, the heart beats too fast, too slow, or with inconsistent manipulations.
Due to the nature of electricity, treating arrhythmias requires additional and specialized training by the physician, who must complete one to two years of additional training beyond the standard Cardiology Scholarship. Cardiac electrophysiologists are doctors who have completed this unique cardiovascular workout.
What does an electrophysiologist do?
The heart muscle produces electrical signals that travel through the heart muscle to contract. These signals are small but can be taken on an EKG machine. The electrocardiogram (ECG) can help, but often the signs that doctors need to see are so small that they cannot be seen or hidden on the ECG. The electrophysiologist can perform ablation studies and / or procedures on your heart's electrical system and timing.
When Do You Need An Electrophysiologist?
In a normal, healthy heart, the upper chambers (atria) and the lower chambers (ventricles) work together, alternately contracting and pumping blood. Sometimes your rhythm shoots up and you have an irregular heartbeat, either too fast (more than 100 beats per minute) or too slow (less than 60 beats per minute). An electrophysiologist can help you cope with arrhythmia, the most common of which is atrial fibrillation, where the upper two chambers shake without coordinating their contractions.
Purpose of electrophysiologists
A cardiologist may recommend an EP study when a standard EKG, Holter monitor, event recorder, stress test, echocardiogram, or angiogram do not provide adequate information to evaluate an abnormal heart rhythm known as an arrhythmia.
The EP study may also be helpful in diagnosing suspected arrhythmia in a patient with arrhythmia symptoms, but this has not been found in other tests.
The purpose and great value of the EP study is that it provides the physician with more detailed information about the electrical activity of the heart than the non-invasive tests mentioned above because the electrodes are placed directly on the heart tissue.
EP studies may be helpful in assessing:
Some tachycardia or bradycardia of unknown cause
Resuscitated patients after experiencing sudden cardiac death
Various symptoms of unknown causes such as chest pain, shortness of breath, fatigue or syncope
Response to antiarrhythmic therapy
Conditions of Electrophysiology
Common conditions that we treat in our laboratory, including atrial fibrillation and other types of arrhythmias. Using cardiac maps, our electrophysiologists can identify the cause of irregular heartbeat and often correct it by ablation. This procedure corrects electrical conduction problems that cause a problematic and abnormally fast heart rate.
Our electrophysiologists can perform additional treatments as needed in the laboratory. For example, if you are experiencing a cardiac defibrillator that provides a slow heart rate or electrical impulses, pacemakers can be set to help the patient's heart return to a normal rhythm after experiencing a severe arrhythmia.
Electrophysiology Procedure
The EP study is an invasive test similar to angiography and is performed in a catheterization laboratory. After the patient is operated on under local anesthesia (or in some cases, general anesthesia), the catheter is inserted into a blood vessel through a site in the groin or neck and guided through the catheter and images of the myocardial fluoroscopy.
Once the catheter reaches the heart, the electrodes on its tip collect data and a variety of electrical measurements are made. This "electrical mapping" helps the cardiac arrhythmia specialist to locate the area where the current is interfering.
The electrophysiologist then administers various medications or electrical stimuli to determine the ability to terminate the arrhythmia and restore normal heart rhythm. Sometimes a specialist will perform cardiac ablation or insert an implanted cardioversion device (ICD) or pacemaker. The procedure usually takes about two hours.
Treatments
Atrial Fibrillation Ablation
Device Interrogation
Electrical Cardioversion
Monitoring
Implantable Cardioverter-Defibrillator (ICD)
Pacemaker Implantation
Study of electrophysiology
When an abnormal heartbeat is found, your doctor or cardiologist may recommend an electrophysiology study (EPS).
This study is performed by an electrophysiologist who inserts one or more specialized electrode catheters in the groin or neck into the blood vessel leading to the heart.
Using catheters, the electrophysiologist sends electrical signals to your heart and records the electrical activity of your heart.
The EPS will help determine:
Source of abnormal heartbeat
What medicines work to treat your arrhythmia
If you need an ICD (implantable cardioverter-defibrillator) or pacemaker
If you need catheter ablation (using a catheter to destroy a very small part of the heart that causes arrhythmia).
Your risk of complications such as cardiac arrest
New Technology and Innovative Procedures
Our ability to perform 3-D models of the heart in real time can help us determine the best treatment options, such as medications, surgical procedures or devices such as defibrillators or pacemakers with remote monitoring by specialized personnel.
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